Table 3.

CRS grading systems

Institution	Grade 1	Grade 2	Grade 3	Grade 4
NCI5	Mild reaction; infusion interruption not indicated; intervention not indicated	Therapy or infusion interruption indicated but responds promptly to symptomatic treatment; prophylactic medications indicated for ≤24 h	Severe symptoms including any 1 or more of the following: a drop in blood pressure ≥20% from baseline, not responsive to fluid within 24 h; grade 3 respiratory dysfunction; grade 3 creatinine indicative of renal dysfunction; grade 3 neurological dysfunction	Life-threatening consequences; vasopressor or ventilator support indicated
UPenn13	Mild reaction; treated with supportive care	Moderate: requiring IV therapies; some signs of organ dysfunction related to CRS; hospitalization for management of CRS-related symptoms including fevers with associated neutropenia	More severe reaction: hospitalization required for management of symptoms related to organ dysfunction including grade 4 liver function test or grade 3 creatinine elevation related to CRS; includes hypotension treated with IV fluids or low-dose pressors	Life-threatening complications such as hypotension requiring high-dose pressors, hypoxia requiring mechanical ventilation